Faculty of Pharmacy, Cyberjaya University College of Medical Sciences, Selangor, Malaysia.
School of Pharmacy, Monash University Malaysia, Selangor, Malaysia.
Eur J Gen Pract. 2021 Dec;27(1):198-210. doi: 10.1080/13814788.2021.1954616.
Task shifting is an approach to help address the shortage of healthcare workers through reallocating human resources but its impact on primary care is unclear.
To provide an overview of reviews describing task shifts from physicians to allied healthcare workers in primary care and its impact on clinical outcomes.
Six electronic databases were searched up to 15 December 2020, to identify reviews describing task shifting in primary care. Two reviewers independently screened the references for relevant studies, extracted the data and assessed the methodological quality of included reviews using AMSTAR-2.
Twenty-one reviews that described task shifting in primary care were included. Task shifted include provision of care for people with chronic conditions, medication prescribing, and health education. We found that task shifting could potentially improve several health outcomes such as blood pressure, HbA1c, and mental health while achieving cost savings. Key elements for successful implementation of task shifting include collaboration among all parties, a system for coordinated care, provider empowerment, patient preference, shared decision making, training and competency, supportive organisation system, clear process outcome, and financing.
Evidence suggests that allied healthcare workers such as pharmacists and nurses can potentially undertake substantially expanded roles to support physicians in primary care in response to the changing health service demand. Tasks include providing care to patients, independent prescribing, counselling and education, with comparable quality of care.
任务转移是一种通过重新分配人力资源来帮助解决医疗保健工作者短缺问题的方法，但它对初级保健的影响尚不清楚。
提供一篇综述，描述初级保健中医生向辅助医疗保健工作者的任务转移及其对临床结果的影响。
截至 2020 年 12 月 15 日，我们检索了六个电子数据库，以确定描述初级保健中任务转移的综述。两名审查员独立筛选参考文献，提取数据，并使用 AMSTAR-2 评估纳入综述的方法学质量。
共纳入 21 篇描述初级保健中任务转移的综述。任务转移包括为慢性病患者提供护理、药物处方和健康教育。我们发现，任务转移可能会改善血压、HbA1c 和心理健康等多项健康结果，同时实现成本节约。任务转移成功实施的关键要素包括所有各方之间的合作、协调护理系统、赋予提供者权力、患者偏好、共同决策、培训和能力、支持性组织系统、明确的流程结果和融资。
有证据表明，药剂师和护士等辅助医疗保健工作者可以在初级保健中承担更多的角色，以应对不断变化的医疗服务需求，支持医生。这些任务包括为患者提供护理、独立处方、咨询和教育，具有可比的护理质量。
